Middle Ear Infection
Take middle ear infections seriously because recurrent
ear infections can lead to deafness. As the brain is
situated near the ear, infection from the ear can spread to the
meninges covering the brain, leading to meningitis. Deafness at
an early age can also hinder your child’s speech development.
SYMPTOMS: The child has a cold for a few days. He wakes with high fever one night, crying
and rubbing his ear.
He remains restless throughout the night. The next morning,
pus is discharged from the ear, after which he stops crying. In some cases of ear infection, hearing
is only
temporarily reduced and usually returns to normal after the
infection is brought under control. Sometimes, a fluid may remain
behind the eardrum even after a cold. This is clear fluid. In
30% of the cases, this also gets absorbed spontaneously within
about 2 months.
TREATMENT: The mainstay of treatment of the middle ear infection is antibiotics, given by
mouth in proper
doses for 10 days. No eardrops should be put in the ear; the ear
should be kept dry to help heal the perforation of the eardrum through which pus had come out. To dry
the ear, clean
the pus nearer the ear lobe with clean linen. To dry the
inside of the ear canal, insert a small wick made from new
newspaper into the ear and let it soak up the pus. Keep changing
the wick every 2 minutes till the ear looks clean and dry. Do
this 3 times a day. The child should not be allowed to go
swimming till he recovers from the ear infection.
Consider the child’s nutrition if he gets recurrent
ear infections. Your doctor may decide to put the child on
some long-term antibiotics. If symptoms suggestive of
enlarged adenoids are present, removal of the adenoids may be considered.
Similarly, if the fluid behind the eardrum persists for
a prolonged period, you may be offered tiny tubes (tympanostomy tubes) to be put in the eardrum to keep
draining the middle ear. Doctors are divided on whether these tubes (also called
gromet) give definite benefit
or not. In older children, a wait-and-watch strategy may be
adopted, because we can easily assess if the hearing is improving
or not. In infants and toddlers, the decision sometimes
tilts in favour of using these tubes because prolonged hearing
loss can affect development of speech around this age.
External Ear Canal Infection (Otitis Extema)
CAUSES: The earwax present normally in our ear protects the external canal against
moisture and germs. Putting anything inside the ear can result in irritation of the
skin and removal of the normal wax, which can predispose the
child to infection. Swimming can also result in otitis extema in
some children.
SYMPTOMS: In this condition, the child does not have a cough or cold but complains of
earache or points towards
his ear. The child does not look too sick. On examination,
the ear canal may look red and we may notice a small boil
inside, which may burst, discharging a small amount of pus.
Except for severe cases, there is no severe pain or high fever.
Itching and mild pain are common features.
TREATMENT: Most cases of otitis extema get better on their own. Antibiotic drops may
sometimes be required,
and only rarely are antibiotics given by mouth. Do not allow swimming for 8 to 10 days.
Foreign Body In The Ear
An insect or a grain or other foreign object may be
lodged in the child’s ear.
MANAGEMENT: In the case of an insect, do not try and remove it until you have put a few
drops of warm coconut
oil into the ear. If it does not come out easily, flush it
out with warm (boiled and cooled) water filled in a syringe
(without a needle).
With a grain or any other foreign body lodged in the
ear, remove it if you can easily do it. Take the child to a
doctor if you are unable to do this. If this is not possible, try
to flush it out with a syringe filled with warm saline water.
Flushing with water should not be undertaken if the child has had
otitis media in the recent past.
Hard Wax
As mentioned above, the ear is normally lined with a
thin layer of wax, which protects it from germs and moisture. Sometimes, this layer of wax can harden and cause
earache or even deafness.
TREATMENT: Consult your doctor about the wax. If that is not possible, put 3 drops of
coconut oil inside the
ear at night for 3 nights. As the wax softens, flush it out
with warm water and a syringe as detailed above. Repeat this
several times. Stop immediately, however, if the child complains
of pain or dizziness.
Deafness
If there is any doubt about the hearing of your infant,
you must consult the doctor as soon as possible. If there is
a family history of deafness, screening of your newborn
can be done to rule out congenital deafness. In selected cases
of childhood deafness, the hearing can be remarkably
improved with the help of cochlear implants.
